FY 2024 Behavioral Health Service Expansion - WCCH serves 31 zip codes (47003, 47102, 47106, 47111, 47126, 47129, 47130, 47138, 47141, 47143, 47147, 47162, 47163, 47170, 47172, 47177, 47229, 47325, 47327, 47330, 47331, 47335, 47339, 47341, 47345, 47346, 47353, 47355, 47357, 47374, and 47393) in southeast and south-central Indiana. The Service Area is rural with the closest metropolitan area approximately 72 miles west in Indianapolis, 47 miles to the east in Dayton and 38 miles north of Austin in Columbus. The opioid epidemic has been called the worst drug crisis in American history. The opioid epidemic has also significantly impacted the service area population. The mortality rate from any opioid overdose in Wayne County was 59.3 deaths per 100,000, 79.9 deaths per 100,000 for Scott County, 83.0 deaths per 100,000 for Fayette County, and 43.6 deaths per 100,000 for Clark County compared to the state of Indiana rate of only 27.8 deaths per 100,000 persons. In 2020, Wayne County also had the highest mortality rate from opioid overdoses out of all 92 counties in the state of Indiana Additionally, the non-fatal emergency department visit rates for a heroin overdose per 100,000 emergency department visits in Fayette and Wayne Counties were over three times the rate for Indiana (29.9, 26.2, and 5.9 respectively). The 2015 HIV outbreak in Scott County, resulting from a high prevalence of injection drug use, along with high prescription and overdose rates, all point to a complex combination of factors shaping poor mental and physical health in the area. Scott County, Indiana ranks in the top 10 percentile of counties in the United States for the following mental health issues in youth under age 18. • Severe depression at 60.3/100,000 • Suicidal idealization is 68.9 per 100,00 • Children with a mental health or behavioral condition who did not receive treatment or counseling was 52.4% • Percentage of students who reported having suicidal ideation in the past year was 12.9% • Percentage of students who reported feeling sad or helpless was 38.7% In addition to the substance use issue the overall population exhibits health behaviors that impact the youth of the Service Area through unhealthy adult behaviors that become multi-generational. The 2022 County Health Rankings for Scott County provide a snapshot of the multitude of chronic health conditions and unhealthy behaviors. Once again, the County ranked 92/92 in Indiana. The 2022 County Health Rankings, ranks Scott County 92/92 counties in Indiana for the poorest health outcomes. The socio-economic status, isolation, rural location, and a myriad of other factors have led to dismal outcomes. To address the need, WCCH will use BHSE funding to expand its Integrated Behavioral Health Team. The IBH Team will consist of 1.7 FTE Nurse Practitioners (MOUD), a 0.2 FTE Psychiatric Nurse Practitioner, a 0.4 FTE Psychologist, a 0.136 FTE Program Medical Director, a 1.0 FTE Case Manager, 0.4 FTE Community Health Worker, a 0.2 FTE Physician Assistant (MOUD), a 1.0 FTE Recovery Coach, a 0.5 FTE LCSW, a 0.5 FTE RN Program Coordinator, and a 0.4 FTE IT Technician. This model will provide increased capacity to address significant care gaps among non-Medicaid eligible individuals with high- acuity behavioral health needs and other focus populations experiencing heightened barriers, such as those who are homeless. The impact will be access to behavioral health, SUD, and MOUD services to 457 NEW patients by December 31, 2025.